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Biomedical subjects

Carlos Jiménez-Ruiz

Publications and source records attributed to Carlos Jiménez-Ruiz.

5 recordsLinked to original sources

Adverse effects of pharmacological therapy for nicotine addiction in smokers following a smoking cessation program.

This multicenter, community-based, prospective, longitudinal study evaluated the safety of nicotine replacement therapy (NRT), bupropion, and combined therapy of NRT and bupropion for smokers seeking to quit, when these therapies were used under real-world conditions following a smoking cessation program. Participants were smokers aged 18 years or older who attended five smoking cessation clinics. Evaluations were made at 15, 30, 60, and 90 days. We investigated the possible existence of adverse effects as well as the severity of each adverse effect and its influence on the treatment course. The study included 904 smokers: 370 received NRT, 413 received bupropion, and 121 received combined therapy. At 15, 30, 60, and 90 days, adverse effects were reported by 43.8%, 33.1%, 22.3%, and 5.7% of subjects, respectively. Adverse effects were significantly more frequent in subjects receiving combined therapy or bupropion alone than in NRT-treated subjects at the 15-, 30-, and 60-day follow-ups. A total of 83 smokers (9.3%) withdrew from treatment and 116 (12.8%) stopped temporarily because of adverse effects. No differences were found in the percentages of discontinuation among the different treatment options. Adverse effects rarely were severe (n=10). Nevertheless, 41 subjects (4.5%) discontinued drug therapy indefinitely and 55 (6.1%) discontinued it temporarily because of mild adverse effects. Pharmacological therapies for smoking cessation are safe as long as they are appropriately prescribed and supervised by clinicians according to clinical practice guidelines. Adverse effects are primarily mild. Nonetheless, mild adverse effects may be perceived by patients as a serious enough problem to cause them to discontinue treatment.

Bupropion↗

Can cumulative tobacco consumption, FTND score, and carbon monoxide concentration in expired air be predictors of chronic obstructive pulmonary disease?

Between 15% and 20% of smokers develop chronic obstructive pulmonary disease (COPD). The aim of the present study was to determine which characteristics of smoking, particularly the Fagerström Test for Nicotine Dependence (FTND) score, were associated with the risk of developing COPD. Data from the IBERPOC epidemiological study were analyzed. IBERPOC was a multicenter epidemiological study including 4035 individuals aged 40-69 years, 1023 (25%) of whom were active smokers. We analyzed the association between smoking characteristics--such as the cumulative consumption of tobacco, FTND score, and expired-air carbon monoxide levels--and the diagnosis of COPD. Among the smokers, 153 (15%) were diagnosed with COPD. A cumulative tobacco consumption of more than 30 pack-years (OR=4.24, 95% CI=2.83-6.36) and the FTND score (OR=1.11, 95% CI=1.02-1.21, for each point increase) were significantly associated with the diagnosis of COPD in the model obtained by logistic regression analysis with the full sample of smokers. Cumulative consumption of tobacco was associated with the diagnosis of COPD. For each point increase in the FTND score, the probability of a smoker developing COPD increased by 11%.

Adult↗

[Effectiveness of a group therapy intervention to quit smoking. Randomized clinical trial].

BACKGROUND: Group therapy is a widely used technique for the treatment of tobacco, alcohol and other toxic addictions. Nevertheless, its effectiveness for smoking cessation remains to be established. Our objective was to evaluate the relative effectiveness of a group intervention versus an individual intervention for smoking cessation. METHOD: Randomized clinical trial of 106 smokers wishing to quit their addiction, who were assigned to two types of intervention: Short Individual Intervention (SII) and Group Intervention (GI). Nicotine patches were administered as supplemental therapy when needed in both instances. Results were assessed by intention to treat analysis. RESULTS: Although smoking cessation rates decreased in parallel with longer follow-up periods in each intervention group (from 39.6 to 26.4% and from 22.6 to 15.1% for GI and SII groups, respectively, at 3 and 6-months), the relative effectiveness was similar during both periods and there was no better response to any intervention at 3-months (relative risk [RR] = 1.75; CI95%, 0.96-3.18) and at 6-months (RR = 1.75; CI95%, 0.80-3.82). Compliance with GI was low and less than 60% of smokers attended to 5 out of 7 GI sessions. CONCLUSIONS: Group intervention (GI) is not more effective than short individual intervention to quit smoking. However, this fact could be due to the low compliance observed with regard to smokers' attendance to GI sessions.

Adult↗

Harm reduction--a treatment approach for resistant smokers with tobacco-related symptoms.

Smokers with chronic obstructive pulmonary disease (COPD) appear to represent a hard-core group, and this presents a dilemma for chest physicians. A reduction in cigarette smoking benefits health, and nicotine replacement therapy (NRT) can aid smoking reduction. Hence we studied the efficacy of nicotine gum in helping hard-core smokers with severe COPD to quit. Seventeen smokers with severe COPD (FEV(1) 38-47% of predicted normal) who smoked >30 cigarettes/day but were unable to quit were encouraged to reduce their smoking as much as possible by using 4-mg nicotine gum. Five gradually reduced their daily tobacco consumption and, 18 months after starting NRT, were smoking an average of 6 cigarettes/day while still using nicotine gum. Compared to baseline, their respiratory symptoms had improved, and both FEV(1) and FVC had increased. There was no improvement in pulmonary function in the group of smokers who did not reduce their cigarette consumption. No adverse events relating to nicotine occurred among the patients who used NRT to reduce their smoking. We propose that this reduction approach should be considered for patients with respiratory disease who are unable or unwilling to stop smoking.

Adult↗